In a previous blog (click here), we have addressed the importance of empathy when adopting a Motivational Interviewing (MI) spirit or attitude. More and more we have become convinced that using MI is less about doing, and more about being. That is, MI has conventions, ways of being in an MI spirit – the confluence of being co-llaborative, com-passionate, engendering autonomy, and evoking internal motivations. That is, just as we take up or adopt an attitude of creating music from an instrument or a way of playing a sport, getting into MI is not about adopting or applying a skill set; instead, it is very much about being in an MI approach such that we are living into Miller and Rollnick’s concept of “arranging conversations so people talk themselves into change based on their own values and interests.” Evoking is at the heart of the MI process and the very word, ‘interviewing’ suggests the primary aspect of being in MI is asking questions to evoke change and we believe that is completely accurate. At the same time, to have evocative impact, all motivational interviewers must be adept at listening, really listening. The next ‘best’ question in an MI session comes from what the interviewee or client has just said and how they said what they said. One way to perceive listening as an art to be developed or honed is to think of listening on 3 levels. Level 1 listenging is about hearing just the literal level of the words being spoken by another person; at the same time, if the listener is in Level 1, it’s easy to slip into multi-tasking and entertain all of the multiplicity of thoughts going on in our heads about our busy day, our next appointment, and a host of other thoughts, all the while assuming we are listening to the cliient’s words. Level 2 listening is being so zoned in or singularly focused not just on what our client is saying, but also what is behind their words, the emotions, the values, the tone, gestures, and facial expressions – it is listening so that we are being ‘over there’ in complete rapport with our clients. Level 3 is about the space around the conversation; level 3 is about trusting intuition and your senses about your client, kind of getting their temperature in the conversation. Simple reflections (recall reflections as the ‘R’ in the OARS’ MI skill set) come from level 1 and a bit of level 2 listening; complex reflections are grounded in and predicated upon listening, really listening at levels 2 and 3. And it takes practice to listen at both levels 2 and 3. Becoming more aware of turning down level 1 listening and turning up the volume on levels 2 and 3 is a huge first step in learning or re-learning how to listen when arranging conversations with our clients. What if we practised levels 2 and 3 listening more in daily conversations that are not work-related? Might MI be more about a strategic form of listening and reflecting back all of what we hear, at all levels, in full service of evoking our clients’ motivations for change? Learning to listen, really listen is a deliberate choice and is very much embedded in Motivational Interviewing.
